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. 2025 Apr 2;13(1):58.
doi: 10.1186/s40337-025-01242-w.

The relationship between food addiction, eating attitudes, and psychiatric symptoms with metabolic control in adolescents with Type 1 Diabetes Mellitus

Esma Kaya Özdemir  1   2 , Sarper İçen  3   4 , Esra Döğer  5 , Yasemin Taş Torun  3 , Nihan Solmaz  5 , M Orhun Çamurdan  5 , Aysun Bideci  5
Affiliations

The relationship between food addiction, eating attitudes, and psychiatric symptoms with metabolic control in adolescents with Type 1 Diabetes Mellitus

Esma Kaya Özdemir et al. J Eat Disord. .

Abstract

Background: Metabolic control is of critical importance in children with Type 1 Diabetes Mellitus (T1DM) for the stabilization of blood glucose levels and long-term health outcomes. Dietary choices play an important role in glucose control and the prevention of diabetes-related complications. This study aims to investigate the relationship between food addiction, eating attitudes, and psychiatric symptoms with metabolic control in adolescents diagnosed with T1DM.

Methods: Participants (N = 100) were assessed using the Yale Food Addiction Scale (Y-FAS), Eating Attitudes Test-40 (EAT-40), and Brief Symptom Inventory (BSI) to evaluate food addiction, eating attitudes, and psychiatric symptoms. Metabolic parameters of adolescents with T1DM, such as body mass index (BMI), HbA1c levels, insulin dosage, duration of diabetes, and the incidence of ketoacidosis and hypoglycemia, were recorded.

Results: The study found that 15% of adolescents had food addiction criteria, and 17% were prone to disordered eating behaviors. The presence of a history of hypoglycemia was related to a higher total symptom score on YFAS and higher total scores, depression, anxiety, somatization, and hostility subscale scores on BSI (p <.05 for all). BMI was positively correlated with anxiety about gaining weight on EAT-40 and higher total scores, depression, and anxiety subscale scores on BSI (p <.05 for all). As the BMI percentile group increased from normal to overweight/obesity, more food addiction symptoms were observed, and significant increases were found in depression, anxiety, negative self-perception, and somatization subscale scores, and the BSI total score (p <.05 for all).

Conclusions: Findings suggest that adolescents with T1DM may have a higher susceptibility to food addiction and eating disorders compared to the rates reported in the general population. Hypoglycemia can be a metabolic risk factor for food addiction in adolescents with T1DM. Psychological problems such as depression, anxiety, and somatization in adolescents with T1DM are associated with poor metabolic control. Further studies are needed with larger and more diverse samples.

Keywords: Adolescence; Diabetes; Eating disorders; Food addiction.

Plain language summary

Adolescence is a difficult period for patients with type 1 diabetes due to problems in following dietary management. Consuming certain foods may become addictive, similar to well-known substance or alcohol addictions, and complicate the treatment of diabetes. This study showed links between food addiction and diabetes-related parameters among adolescents with type 1 diabetes. On the other hand, some of the eating attitudes may be related to increased risk for eating disorders, such as anxiety about gaining weight among type 1 diabetes patients with obesity. Moreover, findings point out that there may be associations between psychological difficulties and poor glycemic control.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013. All procedures involving human subjects/patients were approved by the Clinical Research Ethical Board of Gazi University with date/approval number 07.02.2022/97. Before inclusion, informed consent was obtained from both the adolescents and their accompanying parents regarding the study procedure and the anonymous publication of the findings. Those who did not wish to give informed consent were excluded from the study and received their treatment as usual. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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